National Consultation on the Section 56 Exemption

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Health Canada commissioned the CRISM network to conduct a national consultation on the barriers to accessing treatment options for opioid use disorder. CRISM reached out to over 250 stakeholders, via an online survey and teleconference meetings and submitted a report on the findings in December 2017.

Methadone, a medication primarily used to treat chronic pain and opioid use disorder, is a controlled substance under the Controlled Drugs and Substances Act (CDSA), and activities with it are regulated under the Narcotic Control Regulations (NCR). The NCR required practitioners (e.g., physicians and nurse practitioners) to obtain an exemption under section 56(1) of the CDSA before they can prescribe, administer, sell or provide methadone.

Experts from across Canada cited the section 56 exemption process as a barrier to care and recommended its removal, while also recommending that strategies are in place to maintain appropriate training and monitoring for methadone treatment delivery. On March 21, 2018, Health Canada posted amendments to the NCR that will remove the section 56 requirement and allow licensed dealers and practitioners to provide or prescribe methadone similar to other opioid agonist treatments. The amendments also ease some restrictions on access to diacetylmorphine. These changes will come into effect on May 19, 2018.